Hospital medicines list news 8

Prescribing from the HML - information for hospitals and health professionals

17 October 2013

DHB hospitals started prescribing from a nationally consistent pharmaceutical list on 1 July 2013. The Hospital Medicines List (HML) – Part II of Section H of the Pharmaceutical Schedule – has been developed by clinicians, pharmacists and PHARMAC. It means New Zealanders get access to the same hospital medicines, wherever in New Zealand they are being treated.

Kia ora and welcome to HML News. This is a summary of information we’ve sent to DHB pharmacies over the past month and half. We think this may also be of general interest to DHB people and the wider sector. If you have questions about anything, please call our queries line or talk to your local DHB pharmacy staff.

Interactive HML available online

The good news for pharmaceutical management in hospitals this month is that the second full edition of Section H of the Pharmaceutical Schedule is now available on the PHARMAC website in a XML/interactive format.

The interactive tool allows users to search the most up-to-date HML information all in one place, in a similar way to the community Schedule. This includes being able to:

view the Pharmacode reference when PHARMAC has a contract for the listed product

export list information into excel and other formats for use in local technology systems

easily move between a HML and community Schedule search and see links to other NZ pharmaceutical information sources.

In future releases users will also be able to search and print out individual restrictions’ rules for each pharmaceutical, where these apply.

The online list now includes all the changes and updates made between 1 July and 1 October. From now on, monthly Updates will be made to the interactive database.

PDF versions of the printed Updates and Section H will still be published to the website and hard copies will continue to be sent free of charge for now. The HML second edition books should arrive at DHBs in early November.

Hospital devices consultation begins

Also new on the PHARMAC website this week is information about an important consultation starting on the future management of hospital medical devices in DHBs.

The consultation is open to anyone who wishes to give input to how the PHARMAC model will be best applied to medical devices. There are also open forums happening in DHB venues around the country starting next week. Check the website for the full consultation document, and all the details, including how to sign up to the Devices newsletter to receive direct updates.

HML restrictions waivers

The NPPA policy allows PHARMAC to use wider discretion from time to time which may mean a NPPA application is not required for an HML item with indication restrictions.

An example of this could be when the clinical circumstances mean the general intent of the restriction criteria is met, but some unusual clinical aspect of the patient’s situation means that the technical wording of one of the criterion is not met. PHARMAC may then give a restriction waiver for that patient.

If it appears a patient’s situation may allow for us to agree to a restriction waiver hospitals should get in touch with our HML Queries line.

Access to HML treatments

We’ve been asked from time to time whether DHB patients in different settings, such as outpatient clinics, can be offered HML treatments. Any patient under the care of a DHB hospital can have access to HML-listed treatments, and have this funded by the relevant DHB hospital.

The HML rules define a DHB hospital as “a hospital (including community trust hospitals) and/or an associated health service that is funded by a DHB including (but not limited to) district nursing services and child dental services”.

So if a clinician in an out-patient clinic wants to prescribe a treatment listed in the HML (but not listed in Section B) they can do so under the Rule 8: Community use of Hospital Pharmaceuticals (the 30-day rule) and have the hospital pharmacy dispense it, providing any HML restrictions for that pharmaceutical are met.

Also, if a DHB patient is being treated in a private setting on behalf of a DHB and the HML treatment is available in the private hospital, they can receive and have that treatment funded by the relevant DHB hospital.

NPPA form updates

There are updated versions of all NPPA forms on our website for downloading. There have been some small wording changes. Please replace any copies of the forms that have already been downloaded with these new ones.

HML 0800 queries line – hours we can help you

We have heard that generally DHBs have found the HML queries service useful during the transition so far. Please continue to treat the HML@pharmac.govt.nz and 0800 66 00 50 (option 2) contacts as your first point of call for anything HML-related.

Our queries coordinators are available during our normal information line hours which are Monday to Friday, 9am to 5pm. Outside those hours, you can leave a message via the 0800 line or email us your query. This will be dealt with as soon as possible.

A reminder that if there is an after-hours HML query (such as whether a medicine may be used or not), and there is a clinically urgent situation to be dealt with, the clinically appropriate action should always be taken. However, we would still like to hear about the treatment and the clinical circumstances afterwards – a phone call or email is appreciated.

Managing medicines with restrictions

There is a lot of great work going on in DHBs to manage the HML’s restrictions requirements as much as possible, and that is much appreciated. While we don’t expect every restriction will be adhered to in every case during the transition phase the requirements of the HML do mean there is an onus on prescribers to consider and ensure restrictions criteria are being met, and that this is documented in the patient’s clinical record.

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